Altruism: A Very Powerful Antidepressant

Patient Expert

You know the drill: Depression is a disease of the brain, a biological illness "just like diabetes." You've seen the commercials involving a sad neuron with a "chemical imbalance." You have the pills in your medicine cabinet, prescribed by a real doctor.

It has to be true, right? The people who advocate on our behalf wouldn't lie to us, would they? Our doctors wouldn't be prescribing meds for no reason at all, would they?

Could there possibly be another way of looking at depression?

Cindy Haines, who writes on prevention here at HealthCentral, posted an  intriguing piece  based on a recent study that appeared in the leading journal PNAS. The study found that teens who engaged in pro-social activities, such as charity work, were less likely to become depressed.

Wait, hold on. What happened to chemical imbalance and sad neurons and all that? What does biology have to do with being nice to people? Shouldn't these kids be marinating their synapsis in prescription serotonin-enhancers, instead?

Psychiatrists have long talked about the "biopsychosocial" model of mental illness. The advent of SSRI antidepressants in the late eighties, however, fostered an emphasis on the "bio" at the expense of the "psycho" and the "social." We are lately seeing a swing back in the other direction.

It is all too easy to view the three components as separate entities, which has led to a lot of misunderstanding. The brain science reveals a far more complex picture, say where "social" is mediated through "bio," which influences "psycho," but where "social" can actually change "bio" to result in a more positive "psycho."

(You may need to re-read that last sentence several times very slowly.)

In the case of the PNAS study, this translates into altruistic behavior actually changing the neural wiring of the brain in a way that makes one less prone to future depression.

Keep in mind, Dr Haines was writing in the context of prevention. When you're actually in the throes of a force-9 depression, the last thing you want to do is leave the house to spread love and sunshine. But when the depression eases up, you might want to think of organizing part of your life around helping others.

Two highly instructive books include "The Art of Happiness" by the Dalai Lama and Howard Cutler and "Authentic Happiness" by Martin Seligman. Both books emphasize putting others first, cultivating compassion, and focusing on activities that generate a sense of self-worth. The two books cite a host of studies that show the selfless are far happier people than the selfish.

Dr Seligman uses the term "happiness," in the context of "positive psychology," which is not to be confused with positive thinking. As opposed to traditional psychiatry and psychology, where the focus is on finding what is wrong and fixing it, positive psychology seeks out what is right and builds on it.

To loosely translate: We are depressed. Psychology and psychiatry seek to move us into a state of "undepression." But what kind of a life is "undepression"? Aren't we simply setting ourselves up for another depression? The Dalai Lama and Seligman and others are basically telling us to aim higher. If we can't achieve happiness, at least we can seek to find a meaning in our lives.

In the process, we rewire our brains. We become more resilient. In the final analysis, altruism may be the best preventive medicine.